Flyer Contract development and Management
Selective contracts in GKV The classification and characterization of innovative contract models is not yet conclusive, as it is a young and dynamic process. It has proven practicable to distinguish between input - oriented, process - oriented and output - oriented models. Innovative selective contracts in the GKV system Discount contracts and variants (input - oriented) Cost Sharing Rebate Contract Capitation discount contract Process - and outcome - oriented direct contracts Pay4Performance contract Risk Sharing Contract Pay4Cure contract Value - added contract Benefit Sharing Contract Selective contracts with PKV In the case of contracts with private health insurance, it is not the SGB V that ap- plies, but the German Medicines Act (AMG). This means that they are not bound by the constructs familiar from GKV contracts. However, private health insurance companies have not included any control options in the majority of available ta- riffs. Only in a few care sectors, such as the hospital sector, have they joined the contractual regulations of the GKV. The vast majority of treatments and services are provided through a private treatment relationship, i.e., a contractual relations- hip between the physician and the patient. In this case, the PKV company is not a contractual partner and only assumes the reimbursement of costs for the service settlements from this treatment relationship. The aforementioned facts make it difficult to generate good contract models for private health insurance. Contract development and contract management Contract development Contract management Impact analysis
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